At the American Urogynecologic Society and International Urogynecological Association 2014 Scientific Meeting, it was discussed that there had been an improvement in urinary incontinence in obese women for as many as three years after bariatric surgery. Most of the women reporting urinary incontinence are obese and are reported to be at a 4-fold increased risk over others. Severe incontinence becomes more prevalent the more overweight the woman is. This means that the more weight gains, the worse the incontinence will become with most women.
Studies and Statistics
In a study that was conducted with 1565 women participants, approximately 7% had been involved in urinary incontinence surgery, and 8% had been previously medicated for the problem. The average age of the participants was 46 years, and the majority (86%) were white. The body mass index for most of the participants was 46 m/kg2, which is an indication of severe obesity. Out of the women participating, 22% reported having weekly urinary incontinence issues during the three months prior, while 27% reported daily problems.
After the bariatric surgery, which was either a laparoscopic adjustable band or roux-en-y gastric bypass, the average weight loss was 30% at one and two years, with 29% at three years. The one-year mark also decreased weekly urinary incontinence episodes from 11 to 3. These events increased to 4 per week by year two but stayed at that same level through year three. These findings were statistically significant, and similar results were reported regarding urgency and stress incontinence.
Less than weekly urinary incontinence is referred to as remission status. This remission was pinpointed by approximately 67% of the women in year one, 60% in year two, and 59% in year three. The remission rate was slightly higher for stress incontinence than for urgency incontinence. There were also some complete remissions with no reports of incontinence at follow-up, which was 29% at year one, 27% at year two, and 27% at year three.
The bottom line appears that for every 5% of weight loss achieved, the chances of improved incontinence issues rise to 30%. The women in the test lost approximately six times more, equal to odds of improvement that were 8-fold greater. The older women in the study seemed to have less improvement, showing an odds ratio of only 0.76 for each progressive decline. These studies show that the smallest amount of weight loss can majorly improve patients’ incontinence.
When it comes to weight loss and increased incontinence, the connection seems to be clear. Individuals who have been through bariatric surgery and recovered well seem to have found their urinary incontinence issues to be improved or resolved within the first few years after the surgery. The type of surgery does not appear to be a major factor in the resulting improvement of incontinence. There is a direct relationship between the amount of weight lost and the resulting improvement of incontinence condition.
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